Investigation and analysis of the occurrence of autoimmune hepatitis in the elderly population with Hashimoto′s thyroiditis, and related influencing factors

Abstract

Abstract: Objective To explore the occurrence and related influencing factors of autoimmune hepatitis (AIH) in the elderly population with Hashimoto′s thyroiditis (HT). Methods A total of 152 elderly patients with HT were enrolled from April 2020 to April 2023 in First Affiliated Hospital of Jinzhou Medical University, to investigate the incidence of HT combined with autoimmune hepatitis (AIH). Baseline demographic data of the patients was collected, and their serum levels of antinuclear antibodies (ANA), anti-mitochondrial antibodies, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, thyroid globulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), immunoglobulin G (IgG), immunoglobulin M (IgM), and gamma globulin were tested. Based on whether elderly HT patients were combined with AIH, they were divided into combined group and non-combined group. The influencing factors for the occurrence of AIH in elderly HT population were screened, and a model for predicting the occurrence of AIH in elderly HT population was constructed and validated. Results Among the 152 patients, 28 cases were complicated with AIH, with an incidence rate of 18.42%. There was no statistically significant difference (P>0.05) in the levels of anti-mitochondrial antibodies, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, and IgM between the two groups of patients. The proportion of serum ANA positivity, TGAb, TPOAb, IgG, and gamma globulin in the combined group were 85.71%, (72.51 ± 16.92) IU/mL, (65.29 ± 13.08) IU/mL, (20.35 ± 4.09) g/L, (3.52 ± 0.91) g/L, and (26.83 ± 4.05)%, respectively, which were higher than those in the non-combined group [66.13%, (50.04 ± 15.31) IU/mL, (47.21 ± 12.64) IU/mL, (17.52 ± 3.91) g/L, (3.17 ± 0.84) g/L, and (21.31 ± 3.27)%, P<0.05]. ANA positivity, TGAb, TPOAb, IgG, and gamma globulin were identified as risk factors for the occurrence of AIH in elderly HT population (P<0.05). The sensitivity, specificity, and an area under the curve of the model for predicting the occurrence of AIH in elderly HT population were 0.844 (95% CI: 0.731~0.952), 0.813 (95% CI: 0.706~0.921), and 0.828 (95% CI: 0.721~0.936). Conclusion Elderly patients with HT have a higher incidence of AIH, and the occurrence of AIH is associated with the expression of ANA, TGAb, TPOAb, IgG, and gamma globulin.

Key words: Hashimoto′s thyroiditis, Autoimmune hepatitis, Current situation of the disease, Influence factor

ZHANg Yu, YANG Fan, LIN Ben-rui. Investigation and analysis of the occurrence of autoimmune hepatitis in the elderly population with Hashimoto′s thyroiditis, and related influencing factors[J]. Chinese Hepatolgy, 2025, 30(8): 1115-1119.

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